The psychologist in this setting must understand the necessity of coordinating with the other health care providers particularly in effecting intervention plans. Such psychological intervention plans must be integrated with the whole health-care management program and must not be viewed, especially by the patient as merely optional, or worse, as an inconvenience. Behavior change strategies must necessarily be developed especially for patients who continue having difficulties even after receiving initial diabetes education and behavior change advice. The necessity to integrate however should not be viewed as license to take over the roles of other health care providers.
Preserving the medical provider’s role as primary care manager is more effective to allow tailoring of health management intervention plans to fit the needs of the patient. A behavior modification plan, for example may be developed to avoid high-risk situations. After assessing individual needs, behavior modification plans should be developed to help achieve the main goal which is to lower blood glucose concentration. For example, a plan to help an obese patient with Type II diabetes begin exercising regularly may be developed, including setting realistic goals, scheduling, steps for self-reinforcement as well as lapse response plan.
This of course, includes monitoring by the psychologist of the patient’s progress, improving social support. Other possible ways include helping the patient use environmental cues to improve self-monitoring; assisting and giving motivation or encouraging modifications of high-risk behaviors. In addition, the psychologist may apply his or her skill in counseling to patients with severe complications and have a high risk of emotional imbalances (pp. 48-56)
Generally, barriers may be easily overcome with constant monitoring and support. Meetings should be carefully done so as not to convey to the patient a sense of being coerced. It has been shown that those who feel coercion are less likely to adhere to the recommendations than those who feel more relaxed. Interviews should be done in way that would make the patient feel more motivated and not scared. The psychologist must be adept in recognizing any possible barrier to adherence and must as well be swift in addressing these barriers using his or her psychological skills or through his or her intervention programs (pp. 48-56).